强直性脊柱炎骶髂关节病变的三种影像学表现分析

Three kinds of the image expression about pathological changes of sacroiliac joint relating to ankylosing spondylitis

目的:探讨强直性脊柱炎(AS)骶髂关节改变的X线平片、CT及MRI影像特点,以提高其诊断水平。方法:回顾性分析AS患者的骶髂关节69例X线平片、34例CT、16例MRI的表现特点。结果:临床诊断I级AS患者12例,均行X线、CT检查,但X线仅检出3例(25%),CT检出8例(66.7%),其中9例同时行MRI检查,检出7例(77.8%)。16例II级患者,X线检出9例(56.2%),其中11例加行CT检查,3例加行MRI检查,阳性率均为100%。III～IV级AS的X线、CT、MRI均能检出异常征象。结论:X线平片对典型AS能作出较肯定诊断,但对AS的早期诊断不如CT、MRI,而MRI能显示AS某些最早期的改变。

Objective：To discuss the characteristic of image on X-ray,CT and MRI about changes of sacroiliac joint relating to ankylosing spondylitis（AS） and assist the clinical assessment level of pathological changes,so as to raise its diagnosis level. Methods：To retrospectively analyze the characteristic of image expression in 69 cases X-ray,34 cases CT and 16 cases MRI about the sacroiliac joint relating to AS patients. Results：12 cases who suffered from AS were diagnosed as grade I in clinic,all were examined by X-ray and CT,ouly 3 cases could be diagnosed by X-ray（25%）,while 8 cases by CT（66.7%）,9 cases among 12 were examined by MRI at the same time,7 cases were diagnosed （77,8%）. 16 cases were diagnosed as grade Ⅱ ,9 cases were diagnosed by X-ray （56.2%）,11 cases among them were examined by CT and 3 cases were examined by MR],the positive rate of them are all 100%. All the AS patients in grades Ⅱ- Ⅳ had the unusual sign in image by X-ray,CT and MR].Conclusion：X-ray can make more definite diagnosis for typical AS,but its early diagnosis is not as good as CT and MRI, however, MR] can show the change of AS in some earliest issues.